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How Many/Who HAS HCV in USA
  jules: I estimate there may be 1.5 to 2 million in USA who have ever used injection drugs, in this study 4.2% was prevalence in 35-49 age group but this was 10 years ago so now they are 45-59......IDU was more common among men than women (2 percent vs. 1 percent) and among whites than blacks (1.7 percent vs. 0.8 percent). Among people born before 1955, however, IDU was more common among blacks than whites......"Injection Drug Users in the United States, 1979-2002 An Aging Population"......http://archinte.jamanetwork.com/article.aspx?articleid=411538
"The number and percentage of persons aged 12 or older who were current heroin users in 2012 (335,000 or 0.1 percent) were similar to those in 2011 (281,000 or 0.1 percent), but they were higher than those in 2002 through 2005 (166,000 or 0.1 percent in 2002; 119,000 or 0.1 percent in 2003; 166,000 or 0.1 percent in 2004; and 136,000 or 0.1 percent in 2005), 2007 (161,000 or 0.1 percent), and 2009 (193,000 or 0.1 percent) (Figure 2.4). Recent increases in the use of heroin were also evident in the estimate of past year heroin use.".......http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm
Hepatitis C virus infection in USA: an estimate of true prevalence - 'estimated 5.2 to 7.1 million HCV+ in USA'
Recently, Davis et al. (94) used Markov modelling to estimate that complications of chronic HCV infection would increase drastically over the next 20 years: hepatic decompensation (up 106%), HCC (up 81%) and liver-related deaths (up 180%). These data, along with the results of our study, highlight the burden of HCV infection especially in high-risk populations and underscore the importance of education and prevention programmes targeting these persons before they become infected or before long-term complications develop if already infected


Five Million Americans Infected with the Hepatitis C Virus: A Corrected Estimate
Dr Edlin presented the results of his study in an oral session at AASLD Nov ... www.natap.org/2005/AASLD/aasld_49.htm


HCV & Immigrants......Former Soviet Union in the New York City
Prevalence, Distribution, and Correlates of Hepatitis C Virus Infection Among Homeless Adults in Los Angeles
High Referral of HCV Patients to Specialists But Low Treatment Initiation Rate - Barriers to Care & Treatment
Hepatitis C in the United States Perspective (screening/care), poor screening & care
57% of the number estimated to have HCV infection had actually been tested and identified as infected. In the broader population from which the 30,140 NHANES participants were drawn, 50% of persons who had tested positive for antibodies to HCV and provided information during in-depth telephone interviews were aware of their HCV-infection status before being notified of that infection by the NHANES.3....(38%) had no follow-up HCV RNA testing documented....63 to 77% of people who have tested positive for HCV antibodies - 32 to 38% of all HCV-infected people in the United States - received follow-up hepatitis care.....(63%) had had at least one HCV RNA measurement
Barriers to HCV Screening/Care among IDUs: "Perceptions of drug users regarding Hepatitis C screening and care: a qualitative study"
(MACS Study) Incident Hepatitis C Virus Infection in Men Who Have Sex With Men: A Prospective Cohort Analysis, 1984-2011 'HIV-infection (6-fold), unprotected receptive anal intercourse (3-fold) increase risk for HCV acquisition, low CD4, syphils'
"this study demonstrates that the HCV epidemic in both HIV-infected and -uninfected MSM has been ongoing for decades......This study identified URAI with multiple partners as the sexual behavior carrying the greatest risk for of HCV transmission......Among the 6972 men enrolled in the MACS, 6955 were tested for anti-HCV at study entry, of whom 538 (7.7%) had positive results......HIV infection (IRR, 5.98), unprotected receptive anal intercourse with >1 male partner (IRR, 3.37) were independently associated with incident HCV......Notably, the HCV IR was nearly 8.5-fold higher among HIV-infected compared to HIV-uninfected men.....HIV infection led to a 6- to 8-fold higher incidence of HCV after adjusting for behavioral confounders. Together with our data demonstrating the progressively increasing risk for HCV infection with CD4 counts <500 cells/mm3
Prevalent and Incident Hepatitis C Virus Infection among HIV-Infected Men Who Have Sex with Men Engaged in Primary Care in a Boston Community Health Center....'Worrisome Trend': "HIV-infected MSM should receive annual HCV Ab screening to diagnose and treat infection at earlier stages; higher-risk patients should be screened more often"
HIV+ MSM at Boston Fenway Clinic 6% tested HCV+, among those testing negative who were subsequently retested over several years 6% were HCV+. "HIV+ MSM should receive annual HCV screening to diagnose and treat infection at earlier stages; higher-risk patients should be screened more often"....almost one-third of the chronically infected patients said that they had never been given a diagnosis of HCV....CDC should recommend this.....Adding annual HCV antibody testing to the US Federal Ryan White Program would permit earlier identification of undiagnosed HCV infection and create an instant widespread surveillance system, providing HCV incidence data.....
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